2016-17
FINANCIAL AID OFFICE
VERIFICATION WORKSHEET Your FAFSA was selected for a review process called verification. In the process, the campus will be comparing information from your FAFSA with your Federal tax information, W-2 forms and/or other financial documents. The federal law states that the campus must ask for this information before awarding financial aid. If there are differences between your FAFSA information and your financial documents, corrections will be made to your FAFSA and your information will be reprocessed. You must complete, sign and submit this worksheet along with any documents requested below no later than 30 days prior to the last date of the semester. We cannot continue processing your financial aid application until verification is completed.
A. STUDENT INFORMATION Last Name
First Name
M.I.
UH ID Number/Username
Phone Number
Date of Birth
B. FAMILY INFORMATION DEPENDENT STUDENTS: You are considered a Dependent student if you were
INDEPENDENT STUDENTS: You are considered an Independent student
required to provide your parent’s information on your FAFSA. Complete sections A, B, C, D, E, F and G.
if you were not required to provide your parent’s information on your FAFSA. Complete sections A, B, C, E, F and G.
• • •
•
yourself, your parent(s) you live with (including stepparent), and your parents’ other children, if (a) your parents provide more than half of their support from July 1, 2016 through June 30, 2017, or (b) the children would be required to provide parental information when applying for Federal student aid, and other people if they now live with your parents, and your parents provide more than half of their support and will continue to provide more than half of their support from July 1, 2016 through June 30, 2017
• • • •
yourself, your spouse, if married, your children, if you provide more than half of their support from July 1, 2016 through June 30, 2017, and other people if they now live with you, and you provide more than half of their support and will continue to provide more than half of their support from July 1, 2016 to June 30, 2017
Write the names of family members in your or in your parents’ household according to the instructions above (if applicable). Also write the name of the college for any family member, excluding your parent(s), who will be attending college at least half-time between July 1, 2016 and June 30, 2017, and will be enrolled in a degree, diploma, or certificate program. Attach a separate sheet if more space is needed. Full Name
Age
Relationship
College
Self
C. STUDENT’S (AND SPOUSE’S) TAX AND INCOME INFORMATION 1.
TAX RETURN FILERS Student (and spouse) has used the IRS Data Retrieval Tool, or did not use the IRS Data Retrieval Tool, but will use the Tool to transfer IRS information to FAFSA once 2015 Federal Tax Return is filed. (FAO will use IRS information that was transferred) Student (and spouse) is unable or choose not to use the IRS Data Retrieval Tool in FAFSA. 2015 Federal Tax Return Transcript is attached.
2.
NON-U.S. TAX RETURN FILERS Student completed a 2015 foreign tax return or a tax return with another U.S. territory or one of the Freely Associated States. A signed copy is attached.
UH HILO, UH WEST OAHU AND UH MĀNOA STUDENTS NEED TO CONTACT THEIR FINANCIAL AID OFFICE FOR CAMPUS SPECIFIC FORMS. Page 1 of 2 Rev. 11/2014
2016-17
FINANCIAL AID OFFICE
STUDENT NAME: 3.
UH ID #/USERNAME:
NON-TAX FILERS If you (and/or spouse) did not file and/or are not required to file a 2015 Federal Income Tax Return, list below your employer(s) and any income earned from work in 2015. If you (and/or spouse) had no income earned from work for 2015, enter “0”.
Source (Use the W-2 form or other earnings statement)
2015 Amount (attach W-2/Wage Statement)
D. PARENT(S) TAX FORM AND INCOME INFORMATION (FOR DEPENDENT STUDENTS) 1.
TAX RETURN FILERS Parent(s) has used the IRS Data Retrieval Tool, or did not use the IRS Data Retrieval Tool, but will use the Tool to transfer IRS information to FAFSA once 2015 Federal Tax Return is filed. (FAO will use IRS information that was transferred) Parent(s) is unable or choose not to use the IRS Data Retrieval Tool in FAFSA. 2015 Federal Tax Return Transcript is attached.
2.
NON –U.S. TAX RETURN FILERS Parent(s) completed a 2015 foreign tax return with another U.S. Territory or one of the Freely Associated States. A signed copy is attached.
3.
NON-TAX FILERS If your parent(s) did not file and/or are not required to file a 2015 Federal Income Tax Return, list below your parent(s) employer(s) and any income earned from work in 2015. If your parent(s) had no income earned from work for 2015, enter “0”.
Source (Use the W-2 form or other earnings statement)
E.
DID SOMEONE IN YOUR HOUSEHOLD (AS REPORTED ON THE FAFSA) RECEIVE BENEFITS FROM THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM OR SNAP (FORMERLY KNOWN AS FOOD STAMPS) ANY TIME DURING 2014 OR 2015?
YES F.
2015 Amount (attach W-2/Wage Statement)
NO
DID YOU (OR YOUR SPOUSE, IF MARRIED) AND/OR YOUR PARENT(S) PAY CHILD SUPPORT IN 2015?
YES
NO
If yes, indicate the name of the person who paid the child support, to whom the child support was paid, for whom child support was paid, and the total annual amount of the child support that was paid in 2015 for each child. Name of Person who Paid Child Support
Name of Person to whom Child Support was Paid
Name of Child for whom Support was Paid
Amount of Child Support Paid in 2015
G. CERTIFICATION AND SIGNATURES: By signing this worksheet, we certify that all the information reported to qualify for federal student aid is complete and correct. Student (required)
Date
Parent (required for dependent student)
Date
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.
DO NOT MAIL THIS WORKSHEET TO THE U.S. DEPARTMENT OF EDUCATION RETURN THIS FORM ALONG WITH ANY OTHER REQUIRED DOCUMENTATION TO THE COMMUNITY COLLEGE CAMPUS THAT YOU WILL BE ATTENDING: Community College Hawaiʻi Community College Honolulu Community College Kapiʻolani Community College Kauaʻi Community College Leeward Community College University of Hawaiʻi Maui College Windward Community College
Address 200 West Kawili Street * Hilo, HI 96720 874 Dillingham Boulevard * Honolulu, HI 96817 4303 Diamond Head Road * Honolulu, HI 96816 3-1901 Kaumualiʻi Highway * Lihuʻe, HI 96766 96-045 Ala ʻIke Street * Pearl City, HI 96782 310 West Kaʻahumanu Ave * Kahului, HI 96732 45-720 Keaʻahala Road * Kāneʻohe, HI 96744
Email
[email protected] [email protected] [email protected] [email protected] [email protected] [email protected] [email protected]
Phone (808) 934-2712 (808) 845-9116 (808) 734-9555 (808) 245-8360 (808) 455-0606 (808) 984-3277 (808) 235-7449
UH HILO, UH WEST OAHU AND UH MĀNOA STUDENTS NEED TO CONTACT THEIR FINANCIAL AID OFFICE FOR CAMPUS SPECIFIC FORMS. Page 2 of 2 Rev. 11/2014
